UMMC, Mobility Medical wage war on sleep disorders

Dr. Tandaw Samdarshi with the University of Mississippi Medical Center in Jackson says that in an average lifespan, people will spend more than a third of that time sleeping.

“If you do the math you see that in an average lifespan, we spend 26-27 years sleeping,” he says. “So you can imagine that this is a big part of our life that we are ignoring. If we could just manage that effectively then we would be much ahead in the game.”

More than 70 million American adults and 15 million children say they do not get adequate sleep, according to a University of Mississippi Medical Center cardiology researcher.

Samdarshi is leading a new study at UMMC funded by the National Heart Lung and Blood Institute that will examine the possible links between sleep disorders among African-Americans and cardiovascular disease, hypertension, cancer, depression and diabetes.

Sleep disorders like the common obstructive sleep apnea have become a new public health concern in the United States since early diagnoses began in the 1990s. The Mayo Clinic defines obstructive sleep apnea as “a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep.”

“This may happen several times- the person most of the time may not be aware that this is happening,” Samdarshi says. While studies like Samdarshi’s are still gathering research on the causes of sleep apnea and how it affects the body, the symptoms are sometimes easy to spot.

Extreme daytime sleepiness or fatigue is naturally the most common symptoms. Morning headaches, irritability and memory or concentration problems can also be an indicator. Loud snoring is another very common symptom; patients that snore often sleep on their back or have issues ranging from fat deposits in their neck and throat to the size of their tongue that cause a blocked airway during sleep.

While some patients with sleep apnea are overweight, others are not. Blood pressure generally dips during nighttime sleep and with apnea chemicals build up in the body that send a trigger to the brain and body to stop breathing.

“There’s a drop in the oxygen saturation,” Samdarshi says. “That’s one reason the brain gives jolts and breathing stops and starts.”

The result is not only a decrease in oxygen intake into the body but also the sleep cycle itself is rudely interrupted. Samdarshi is also concerned that longterm issues could damage the heart.

“The health consequences for sleep apnea are associated with many chronic conditions like hypertension or arrhythmia,” Samdarshi says. “People may also be subject to congestive heart failure because they have obstructive sleep apnea.” Type 2 diabetes and stroke have also been associated.

Patients curious about sleep disorders or who think they may have one need to first check with their doctor before seeking treatment. Simple surveys that assess a person’s overall sleep quality can be taken and physicians can order a polysomnography or sleep study to get the most comprehensive feedback.

Overnight sleep studies have become a very conventional way to test for a sleep disorder. Multiple electrodes are hooked to a patient and collect data throughout the night while they are asleep in a special lounge. Pauses in breathing and oxygen saturation levels are checked.

Continuous positive airway pressure (CPAP) is to date the most effective way to treat most cases of sleep apnea. Using technology similar to a hair dryer, the machines blow air at different pressure levels from a humidifier and a face mask through the mouth and windpipe. The pressure helps keep lazy airways in apnea patients open while they sleep during the night.

While early CPAP models were bulky and noisy, newer models like the Philips Respironics REMstar are barely louder than a ceiling fan. Models range in price from $400-800 and are typically covered by insurance.

Danyelle Carroll at Mobility Medical in Flowood demonstrates how one of the company’s CPAP sleep apnea masks works. (Photo by Stephen McDill)

Some masks can seem claustrophobic at first, but Manning works with each patient to find the best equipment. Masks can go over the nose for mouth breathers while others go over the whole face. Some resemble the oxygen masks worn by fighter pilots while others cover the whole face like firefighter masks.

“It’s kind of like Goldilocks and the three bears,” says Mobility Medical CEO Danyelle Carroll. Also a registered nurse, Carroll compares CPAP treatment to the running and aerobics craze of the 1980s. “It got a lot of media attention and people were starting to see the benefits.”

The best testimonials for CPAP come from Carroll’s own customers. “They say they have energy,” she says. That increased energy has led some patients to exercise more and lose weight, an extra way to fight back against obstructive sleep apnea.

“I tell my patients this is the most treatable thing you can get,” Manning says. “It’s a machine at your home. You don’t have to do MRIs. You don’t have any doctor’s visits. This is a simple therapy. There’s no pills involved.”